Wound edge protector



Oct. 17, 1967 H. w. HARROWER 3,347,227

WOUND EDGE PROTECTOR Filed Dec. 11, 1964 VEN TOR. HAROLD HARROWERATTORNEY United States Patent Oflice 3,347,2217 Patented Oct. 17, 19673,347,227 WOUND EDGE PROTECTOR Harold W. Harrower, 35 Maple Crest Drive,Smithfield, R.I. Filed Dec. 11, 1964, Ser. No. 417,560 9 Claims. (Cl.128132) The present invention relates to improvements in surgical woundprotection.

An object of the present invention is to provide an improved woundprotector wherein an entire surgical wound surface is protectivelycovered.

Another object of the present invention is to provide an improved woundprotector wherein it can be inserted easily into asurgical wound cavityso as to cover the entire peripheral surface as well as adjacent innerand outer surface portions thereof.

I Still another object of the present invention is to provide animproved wound protector according to the previous object wherein thespace occupied thereby is minimal and the protector is transparent sothat the surgeon can see and work as though no protector were in use.

A further object of the present invention is to provide an improvedwound protector in accordance with foregoing objects where in theprotector is self-retaining so as to obviate the need for any sutures orother holding devices.

A still further object of the present invention is to provide animproved wound protector which is:

(a) Impervious to moisture, body fluids, bacteria and cancer cells.

(b) Non-irritating to wound surfaces.

(c) Strong but pliable to conform to Wound contour and to allow forpurposeful distortion of the wound by retractors.

(d) Readily sterilized or is disposable.

(e) Capable of being inverted upon itself so as to cover the organswithin the wound to facilitate closure of the wound.

Various other objects and advantages will become apparentfrom thedetailed description to follow.

In the drawings:

FIGURE'l is a plan view of a wound edge protector according to thepresent invention;

FIGURE 2 is a side elevational view thereof;

FIGURE 3 is a side elevational view thereof in a compressed form;

FIGURE 4 is an end elevational view of the protector shown in FIGURE 1;

FIGURE 5 is a detail sectional view taken substantially along the planeof line 5-5 in FIGURE 4;

FIGURE 6 is a perspective view showing the protector in place in use,with part in section;

FIGURE 7 shows the protector in a folded over form.

Referring more particularly to the drawings wherein like numerals applyto like parts throughout, it will be seen that I have provided animproved Wound edge protector 10 which can be manufactured in a numberof siz s for use in incisions of similar variations in size.

The protector 10 is comprised of a pair of flexible rings 12, 14 joinedby a thin sheet 16 of flexible material formed to tubular shape. Therings can be preformed to endless shape or formed by lengths of stockarcuated and joined at their ends, as by clips, not shown. In any eventthe stock should have sufllcient preforming to give a generally ovalshape, as viewed in FIGURE 1, yet be resilient and flexible so as to beeasily flexed for insertion through a wound opening as will presently bedescribed. There are a number of suitable plastics from which the ringscan be made among which I have found nylon and Teflon, by way ofexample, as being highly suited to the purpose.

The thin sheet is preferably made of a plastic which has certainphysical and chemical characteristics. The plastic must be impermeableto fluids and bacteria, physiologically inert, unafliected byautoclaving or sterilization i ethylene oxide, free of electrostatichazard, resistant to melting, non-flammable if touched by cautery, andsomewhat elastic. Also, the material must be formable in thin,transparent, and flexible sheets. Polyvinyls are highly suitableplastics for this purpose and have been found in actual tests to fillthe requirements set forth.

The tubular form of the sheet 16 can be effected by preforming stock tothat shape or, preferably, by forming a flat sheet of predeterminedwidth to cylindrical form and sealingly overlapping the ends as at 18,in FIGURE 2. The longitudinal side edges then, respectively, can befolded about the rings and sealed as at 20, in FIGURE 5, to thus providea unitary structure ready for sterilization and packaging.

For the purpose of packaging, the protector can be compressed with onering 12 against the other ring 14 as shown in FIGURE 3.

In use, the wound protector 10 is especially useful in abdominalincisions. FIGURE 6 shows a portion of a patients abdomen at A with anincision having been made. The layers through which the incision is madeinclude the skin 22, subcutaneous tissue 24, anterior fascia 26, muscle28 and peritoneum 30. At the incision these layers and the adjacentinterior and exterior surfaces 32,

.34, respectively, constitute the wound edge. The wound edge is subjectto contamination by the hands, retractors or other instruments'whichmust be introduced through the wound opening. The wound edge can besoiledwhenever the biliary, intestinal, or genitourinary tracts areopened or a cyst or abcess drained.

In the past, a surgeon has customarily wrapped a laparotomy pad overeach side of the Wound but this has proved unsatisfactory because thepads become moist, slip out of position and are bulky. Prioralternatives of rubber dam or plastic sheeting have provedunsatisfactory unless sewed to the peritoneum, which takes time. t

The protector of the present invention has been found idea ly suited tothe needs of Wounds such as here described.

The wound protector, after the incision is made, is squeezed together sothat one of the rings 14 has its longitudinal side portion 36, 38pressed together. The ring 14 can thus be inserted through the woundopening and allowed to expand to its normal form within the wound. Thering 14 will thus be positioned on the inside of the peritoneum 30 overthe surface portion 32 as seen best in FIGURE 6. The outer ring 12 willnaturally similarly overlap the skin edge surface at 34 and the sheet 16will contact the entire wound surface and protectively cover the sameand seal it from contamination and infection. Obviously, the protectorutilizes substantially no space and aids in holding the wound open.

After the surgeon has completed his Work in the Wound, the woundprotector serves an additional important function. The intestines at 40must be held in when the surgeon closes the wound. To do this, the ringside portion 42 is folded over beneath the other ring side portion 44 toadjacent the ring side edge portion 38 and the portion 44 is folded backover to adjacent the ring side portion 36. Thus the upper or outer ringis inverted and positioned within the wound and the plastic sheet isstretched acrOS the center of the wound. FIGURE 7 shows the protectorwhen so folded. The surgeon can then close the wound except for a smallend opening through which the protector is extracted and then closing iscompleted.

By way of information, the thickness of the abdominal wall may vary fromone to three inches. Thus the width of the sheet 16 between the ringsmust be related to this dimension and the ability to be folded over ashere de- 3 scribed. A width of about four (4) inches has provedsatisfactory.

In view of the foregoing it is believed that I have provided a woundedge protector which fulfills the objects hereinbefore enumerated.

As this invention may be embodied in several forms without departingfrom the spirit or essential characteristics thereof, the presentembodiment is therefore illustrative and not restrictive, since thescope of the invention is defined by the appended claims rather than bythe description preceding them, and all changes that fall within themetes and bounds of the claims or that form their functional as well asconjointly cooperative equivalents, are therefore intended to beembraced by these claims.

I claim:

1. A wound cavity and edge'protector comprising a pair of flexible andresilient rings preshaped to arcuate form, a sheet, of flexible materialimpervious to body liquids and solids and having a thinness such that itwill conform closely to the wound surface and being of openendedsleeve-like shape having a size such that its end edges can be joinedrespectively with said rings each end edge of said sheet being joinedwith a respective one of said rings to provide an endless walltherebetween, one of said rings being compressible and initiallyinsertable into a wound cavity of slightly smaller size than the ringand allowed to expand substantially to its normal form at the base ofthe cavity, the other of said rings retainable exteriorly of and in aself-retaining manner to overlap the skin edge surface ofthe wound, withthe flexible wall protectively covering the entire wound surface.

2. A wound edge protectoras defined in claim 1 With said sheet having awidth selected so as to provide a predetermined area between said rings.

3. A wound edge protector as defined in claim 1 wherein the sheetmaterial consists of a transparent, polyvinyl material with each edge ofsaid sheet being folded back upon the sheet and about a respective oneof said rings and bonded to the sheet so as to form a unitary structurewith the rings.

4. A wound edge protector as defined in claim 1 wherein the thin sheetis a pliable polyvinyl material with each edge of said sheet beingfolded about a respective one of said rings and bonded to the sheetportion adjacent the respective ring, said tubular form being ofpre-selected length and with the sheet having a width selected so as toprovide a predetermined area between said rings to facilitatefabrication in a predetermined range of sizes.

5. A surgical wound edge protector as defined in claim 1, wherein theflexible rings, are of endless resilient form,

and the flexible sheet is a transparent polyvinyl material, each edge ofsaid sheet being folded about a respective one of said rings and bondedto the sheet portion adjacent the respective ring, said sheet having awidth selected so as to provide a predetermined area between said rings,said sheet Width and material being such that either ring can beinverted in relation to the other ring.

6. A wound edge protector as defined in claim 1 wherein therings arepreshaped to a generally oval configuration.

7. A surgical method comprising:

(a) making an incision wound of predetermined size in the body of apatient to produce a surgical cavity,

(b) utilizing an aseptic surgical wound edge protector which embodies apairof spaced apart, resilient endless ring members interconnecting aflexible walled body having an open tubular form and fabricated oftransparent pliable sheet material impervious to body fluids and solids,and of a size slightly larger in circumference than the open incision,

(c) compressing one resilient endless ring member to conform to thegeneral longitudinal dimension of the cavity, (d) inserting the saidendless ring member into the base of the cavity, (e) allowing the saidring member to expand substantially to its normal form within the baseof the cavity, (f) initially retaining the other endless ring memberexteriorly of the surgical cavity, with the flexible open tubular wallportion protectively covering the entire peripheral wound surface in aself-sustaining manner and aiding to hold the cavity open duringsurgery. 8. A surgical method as defined in claim 7 subsequentlyincluding inverting the exteriorly disposed ring member in relation tothe first-mentioned ring member while simultaneously compressing andinserting it into the base of the cavity adjacent to the first-mentionedring member whereby the walls of the protector are disposed contiguouslyover and serve to hold down the body organs within the cavity therebyfacilitating more expeditious suturing of the wound after surgery.

9. A surgical method as defined in claim 8, further including extractingthe wound protector from the wound just prior to final suturing.

References Cited 1 UNITED STATES, PATENTS 2,170,060 8/1939 Meyer 229-352,335,293 11/ 1943 Meyer 206-4534 2,778,362 1/1957 Pallock et a1 128-2833,076,458 2/ 1963 Mason 1284-283 3,111,943 11/1963 Orndorlf 128132 ADELEM. EAGER, Primary Examiner.

1. A WOUND CAVITY AND EDGE PROTECTOR COMPRISING A PAIR OF FLEXIBLE ANDRESILIENT RINGS PRESHAPED TO ARCUATE FORM, A SHEET OF FLEXIBLE MATERIALIMPERVIOUS TO BODY LIQUIDS AND SOLIDS AND HAVING A THINNESS SUCH THAT ITWILL CONFORM CLOSELY TO THE WOUND SURFACE AND BEING OF OPENENDEDSLEEVE-LIKE SHAPE HAVING A SIZE SUCH THAT ITS END EDGES CAN BE JOINEDRESPECTIVELY WITH SAID RINGS EACH END EDGE OF SAID SHEET BEING JOINEDWITH A RESPECTIVE ONE OF SAID RINGS TO PROVIDE AN ENDLESS WALLTHEREBETWEEN, ONE OF SAID RINGS BEING COMPRESSIBLE AND INITIALLYINSERTABLE INTO A WOUND CAVITY OF SLIGHTLY SMALLER SIZE THAN THE RINGAND ALLOWED TO EXPAND SUSBTANTIALLY TO ITS NORMAL FORM AT THE BASE OFTHE CAVITY, THE OTHER OF SAID RINGS RETAINABLE EXTERIORLY OF AND IN ASELF-RETAINING MANNER TO OVERLAP THE SKIN EDGE SURFACE OF THE WOUND,WITH THE FLEXIBLE WALL PROTECTIVELY COVERING THE ENTIRE WOUND SURFACE.